A review of central retinal artery occlusion: clinical presentation and management

Abstract

Central retinal artery occlusion (CRAO) is an ophthalmic emergency and the ocular analogue of cerebral stroke. Best evidence reflects that over three-quarters of patients suffer profound acute visual loss with a visual acuity of 20/400 or worse. This results in a reduced functional capacity and quality of life. There is also an increased risk of subsequent cerebral stroke and ischaemic heart disease. There are no current guideline-endorsed therapies, although the use of tissue plasminogen activator (tPA) has been investigated in two randomized controlled trials. This review will describe the pathophysiology, epidemiology, and clinical features of CRAO, and discuss current and future treatments, including the use of tPA in further clinical trials.

Concerning central retinal artery occlusion (CRAO) and cerebral stroke

“…2 We agree with McLeod 3 that penumbral retinal tissue viability can persist as half of our patients did not fall into the carotid occlusive disease group. This concurs with Kottow and Hendrickson, 4 who found anterior segment neovascularisation following CRAO, as well as Brown,5 who reported a case of neovascularisation following CRAO due to presumed single mitral valve embolus in the absence of carotid disease.…”

Mean platelet volume in patients with retinal artery occlusion

“…Thrombosis resulting from atherosclerotic plaques is the major cause of CRAO (14) . Rupture of an atherosclerotic plaque triggers platelet aggregation and consequently thrombus formation.…”

Acute Visual Loss

“…Arteritic CRAO cases should be treated promptly with intravenous high-dose steroids to prevent blindness of the contralateral eye. 17 …”